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Chiropractic Research Review

Clinical Management of Orofacial Pain

Pain and dysfunction of the area around the face and mouth can be detrimental to such basic functions as eating, talking and swallowing. The orofacial system is comprised of the temporomandibular joint (TMJ), disc, masticatory musculature, and cervicocranial region.

Although orofacial pain is a common recurrent problem in many patients and is often a key symptom of other cervical disorders, simple screening procedures are not well known by clinicians.

This article reviews the mechanisms of orofacial pain, including a review of selected literature. Topics discussed by the authors include functional anatomy of the orofacial region, pathologic considerations, screening tests, differential diagnoses, and treatment strategies. The treatment strategies for orofacial dysfunction discussed and described in the article are the mouth opening movement pattern, the hyoid mobility test, and the TMJ mobility screen. Treatment procedures discussed include trigger-point therapy for the muscles of mastication, mobilization of the TMJ, and isometric facilitation of the digastricus muscle.

Conclusions Orofacial pain may result from numerous causes, including articular, myofascial, cervical spine referral, fibromyalgia, degenerative disease, and psychosocial factors. The authors suggest that the orofacial region be routinely screened for dysfunction in cases of head or neck pain.

Skaggs C, Liebenson C. Orofacial pain. Topics in Clinical Chiropractic 2000:7(2), pp43-50. Reprints: (800) 638-8437

Chiropractic Research Review

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